Many people are living with seriously debilitating diseases. While medicine can serve as a means to prolonging a patient's life, many patients still have significant difficulty in interacting with and functioning in their environments. The goal of medical therapies and technologies is to enable the patient to interact with their environment as much as possible for as long as possible—in other words, to adapt a patient's limited abilities to still function as normally as possible. This benefits patients and caregivers alike, as the patient continues to be as productive and interactive as possible while relying as little as possible on caregiver resources.
In particular, many patients suffer from reduced muscle function or control. Underlying causes include diseases of the muscle, such as myopathies, dermatomyositis, polymyositis, and muscular dystrophy, and diseases of the nervous system, such as amyotrophic lateral sclerosis (ALS, often known as Lou Gherig's disease, and often accompanied by severe speech impairment), Bell's palsy, botulism, Guillain-Barre syndrome, myasthenia gravis, neuropathy, poisoning, polio, stroke, injury, paralysis, and Parkinson's disease (and other motor system disorders). Those afflicted with these diseases lose, or never had, the capability which most people are blessed with of interacting with and directing their environment. As an example, some patients may not have strength to move their body to a comfortable position in bed, a particular problem for those who are confined to bed for extended or indefinite periods, and must somehow shift their weight to avoid bed sores. For such patients, motorized electric hospital beds have been developed with controllers, such as remote control pendants, intended to allow the patient and caregiver to easily adjust the bed. These controllers are typically equipped with many buttons that patients or caregivers can press to actuate various bed motors that control such functions as raising and lowering the head or feet, tilting the bed, and moving the bed, among other settings.
In not a few cases, the patient may lack the ability to manipulate buttons, even large ones, or may not possess the dexterity to move between the multiple buttons and controls necessary to direct the various functions. In these cases, the controller is then typically used by the caregiver—when a caregiver is even present—who must guess the settings needed to make the patient comfortable. This is a slow, frustrating process for both patient and caregiver, especially if a patient cannot verbally communicate, and made even more so when adjustments are required in the middle of the night.
Field of the Invention
This invention relates to electronically communicating one or more users' intended commands. In particular, it is directed towards at least partially enabling handicapped persons to communicate their commands to one or more devices.
Description of the Related Art
The long felt need for enabling handicapped people to interact more with their environment has led to the creation of a number of tools and devices. Current standard input technologies include push buttons, switches, remote controls, and knobs. Examples of other control means for disabled persons include sip-and-puff switches, eye-tracking systems, voice control systems, joysticks, touch screens, head control systems, and tongue control systems. Such systems may be less than desirable for reasons including: difficulty to operate, tediousness, inability to operate, obtrusiveness, and unsightliness.
Many simple controls have been adapted to use by persons with various handicaps by superficial changes in geometry and surfaces. Larger knobs and color-coded buttons, for example, are obvious changes intended to provide a measure of assistance. These alterations, however, are often inadequate: larger knobs are of little use if a user cannot even turn a knob, and color-coded buttons avail nothing if one's hand is shaking badly.
Input methods intended to more directly address user needs include familiar technologies such as sip-and-puff (SNP) switches, which can be problematic during sleep and for those with sleep apnia or breathing troubles, where a positive air pressure system or ventilation system may interfere with operation of the SNP device. Multi-level and multi-input switches such as joysticks, potentiometer-based switches, and variable output switches seek to offer more fine-grained and versatile control via one (or at least fewer) input methods, but can present nearly insurmountable challenges to many patients, such as those with loss of fine motor movement or significant tremors. Similarly, tilt switches require ability to tilt some part of body to a measurable and repeatable degree and are prohibitively restrictive for individuals with extreme impairments. Additionally many assistive switch-based interfaces are designed only for use with one particular device, a wheelchair being a very common example.
Various interfaces are available which employ some form of touch or grip-based inputs, both digital and analog. While these can often be very intuitive for a fully functioning user, they typically only offer calibration adjustments, but no ability to adjust the activation parameters to a particular user's capabilities, and thereby requiring a very precise level of control to consistently and accurately activate the desired commands. In addition, such devices are typically not configured to remap existing control inputs in order to serve as a user-customized controller without significant hardware and/or software changes. Further, many are specifically limited to mobile or computing devices, with practically no options for extending the control means to other devices and functions.
Yet other controllers seek to provide a means of remapping a standard control interface to a more advantageous interface for able persons with specific needs or disabled persons with specific handicaps. Such systems include tongue-based control, eye-tracking technology, finger-worn keyboard and/or mouse replacements (or other similar body-wearable devices), and shoulder switches. Various entities are actively exploring tongue-based control for people with limited muscle strength and control, but the technology faces inherent drawbacks in its cumbersomeness to use and its obvious failure for those with tongue paralysis or impairment from conditions such as bulbar palsy or ALS. Further, some tongue controllers require a permanent or semi-permanent magnet or other object in the user's mouth, which may be uncomfortable or dangerous, particularly when sleeping or undergoing certain imaging procedures, such as MRI. Although many people have found eye tracking helpful, it requires considerable complexity and cost to implement, and is subject to additional environmental factors limiting its performance, such as flickering lights or shadows, requirements for minimum brightness levels to properly function, tired eyes, or movement of the eye tracking system. Currently known shoulder switches are limited by the dexterity and strength required of the shoulders, difficulty in body positioning and posture, and a maximum of one output for every means of input, thereby limiting the system to two control outputs.
Other devices include input extending controllers that seek to offer a universal replacement for multiple control interfaces. Such devices include combination keyboard and mouse replacements such as finger mounted unified input methods, controllers of multiple devices including property management controllers, nurses' station controllers, and universal remote controls. These devices often require considerable dexterity, are very slow to operate, and provide no assistance unless the person is able to operate at least one of a very restrictive set of possible controls. Further, many of these devices are restricted to use only in conjunction with a particular device (e.g. a wheelchair control that also offers a nurse's bell or television controller), and so have limited application.
State-based controllers and controllers with a hierarchy of available control options that are cyclically presented for actuation by a single control set are offered for both able people as well as for persons with various types and degrees of disabilities. Regrettably, these systems are often ‘scanning style’ or window-of-opportunity based, requiring very specific timing of inputs, rendering them ineffective for people with severe disabilities that negatively impact their abilities to meet the timing requirements; are not ergonomic; are often slow to operate, especially when controlled only by one switch; and have limited input options (such as regular switches and knobs or SNP switches) that require considerably dexterity and thereby render the system unusable by those with severe dexterity loss. Many such interfaces are also expensive due to the displays employed.
Further, many control means rely on digital transducers with one bit of resolution, typically making the interface unadaptable to the needs of the user. This lack of adjustability frequently renders the device of limited to no utility for people with severe impairments. Still other devices seek to rectify perceived deficiencies in control means by accepting analog inputs and providing analog signals out (such as joysticks for wheelchair controls); however, analog outputs are largely inadequate as control signals for most device functions, which often require binary, on/off, yes/no type inputs. Thus, these types of control means are unable to remap most standard control means. Finally, other control means fail to provide any form of feedback to the user, which may often limit the user's ability to know what will happen when a given input means is activated, thereby leading to non-usage, or to uncomfortable, embarrassing, or dangerous situations.
As the computer and mobile device industries continue to develop new variations, and the phone and tablet industries in particular proliferate, an increasing number of software solutions are offered for use by able and disabled persons to extend control over their environment from a familiar user interface—monitoring heart rate, controlling insulin pumps, opening a garage door, ordering pizza, and remotely controlling a 3D printer with an iPhone are only a few examples. However entertaining and convenient these functions may be, they are inherently limited by the hardware interface required to interact with the software. A person lacking significant fine motor control, for example, will likely find little value in an iPhone based interface for controlling all the devices surrounding him; however close to his fingers the means for actuation may be sitting.
Clearly, an improved means is needed for remapping and/or relocating functions from standard, complex control interfaces to a control means adapted to the particular needs of the user, and capable of utilizing for control of those functions the limited range of physical inputs the user is able to reliably control.